31/417
| Place of Death: County |
Kenosha |
| City |
Kenosha |
| Full Name of Hospital or Institution |
Kenosha Hospital |
| Length of Stay |
|
| Usual Residence: State |
Wisconsin |
| County |
Kenosha |
| City |
Pleasant Prairie Twsp. |
| Street Address |
R 2, Box 774 Kenosha |
| Name of Deceased |
Marie Kyncl |
| Date of Death |
March 12, 1963 |
| Sex |
Female |
| Color or Race |
White |
| Married, never married, Widowed, Divorced |
Widowed |
| Date of Birth |
August 5, 1879 |
| Age |
83 |
| Usual Occupation |
At home |
| Kind of Business or Industry |
|
| Birthplace |
Susice, Bohemia |
| Citizen of What Country |
USA |
| Father's Name |
Matthew Mukensnabl |
| Mother's Maiden Name |
Unknown |
| Was in U.S. Armed Forces? |
No |
| Social Security No. |
|
| Informant |
Otto Kyncl, Son |
| Name of Husband or Wife, If Alive |
|
| Age of Husband or Wife, If Alive |
|
| Cause of Death |
Cirrhosis, portal |
| Antecedent Causes |
|
| Interval between Onset and Death |
2 mos. |
| Other significant conditions |
Hypertensive CVR disease |
| Attended |
Nov. 11, 1958 to Mar. 12, 1963 |
| Last Saw Alive |
Mar. 11, 1963 |
| Death Occurred At |
6:52 AM |
| Physician |
David N. Goldstein MD |
| Address |
Kenosha, Wis. |
| Date |
3-13-63 |
| Burial |
March 14, 1953 |
| Cemetery |
Green Ridge Cemetery, Kenosha, Wisconsin |
| Name of Funeral Home and Address |
Bruch Funeral Home, |
| 3503 Roosevelt Road, Kenosha, Wisconsin |
|
| Filed |
3-14-63 |
| Registrar |
Margaret S. Hadquilt M.D. |
| Funeral Director |
George J. Bruch |
|
